Medical Coding Auditor (Per Diem)

 

Medical Coding Auditor (Per Diem)

 

What you will be doing:

The Medical Coding Medical Coding Auditor conducts clinical coding and documentations audits as defined by client contracts for audit service according to operational guidelines.  The Medical Coding Auditor staff will also contribute to the ongoing development and refinement of proprietary audit tools.  The A Medical Coding Auditor position will participate with educational activities and coding instruction presentations as required by the deliverables of the contract and will be required to provide formal audit feedback as part of the external audit service projects as well a margin improvement projects.

Key Responsibilities

Client Related Duties – 15%

• Coordinate and oversee the external audit process for assigned clients.

• Ensure adherence to State and National Practice Standards for coding.

• Generates narrative audit summary reports as needed

• Serve as an official resource for coding related questions from the coding staff.

• Provide project status reports to operational leadership, as requested.

Auditing Team Duties – 70%

• Assures external coding audits are completed accurately and timely                                                                         

• Conducts coding audits adhering to nationally recognized coding guidelines and standards  

• Generates narrative audit summary reports as needed.          

• Perform auditing for a broad spectrum of cases                                                                                            

• Provides input and advice regarding educational topics based on audit trends  

• Represents company via professional meeting attendance and communication

• Interacts with audit peers, manager, coding staff, and operations team

• Abides by the Standards of Ethical Coding as set forth by AHIMA

• Maintains appropriate QA/QI and/or productivity logs or record entries

• Additional duties as assigned

Maintain Coding Knowledge and Serve as Coding Expert – 10%

• Attend internal and external meetings, as needed and requested to provide input and act as a coding information resource/expert.

• Ensure compliance with all regulatory agencies. Ensure HIPAA compliant at all times.

• Maintain all CEUs required for position and attend educational seminars as needed.

Excellence – 5%

• Demonstrate a commitment to excellence in serving the client.

• Demonstrate the Premier Core Values of: Integrity, Quality, Team, Continuous Improvement, Expertise, and Innovation.

​Required Qualifications

Work Experience:

Years of Applicable Experience - 4 or more years

Education:

High School Diploma or GED (Required)

 

Required Certifications/Licensing

RHIA, RHIT with additional coding certification or equivalent experience preferred.  Associate or bachelor’s Degree in related field with additional coding certification (CCS, CCS-P, CPC)

Preferred Qualifications

Skills:

• Prior experience in development of audit-driven educational programs desired.
• Broad-based audit experience with inpatient and outpatient ICD-10-CM/PCS and CPT coding.
• Requires strong interpersonal communication skills, both verbal and written
• Requires a high level of coding accuracy and attention to detail
• Experience with using multiple encoders and systems
• Excellent oral and written communication skills – must be detailed and articulate
• Strong knowledge of Microsoft Word, Excel, PowerPoint, and Outlook is required
• Inpatient Auditor candidates must demonstrate a comprehensive knowledge of the DRG structure and regulatory requirements.
• Outpatient Auditor candidates must demonstrate advanced knowledge of APC-based reimbursement, medical necessity documentation requirements, guidelines for Observation services and any relevant coding and documentation guidelines for specialty care areas.  Working knowledge of how to research within the Medicare Claims and Processing Manuals is essential.

Experience:

• Minimum 5-7 years’ experience in HIM field with a concentration on medical coding, documentation review and auditing is required

Education:

Associate or bachelor’s Degree in related field

 

Additional Job Requirements:

• Remain in a stationary positi